Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | ME88962 | FL |
N | 207YS0123X | Facial Plastic Surgeon | ME88962 | FL |
NPI | 1255350864 |
---|---|
Provider Name | Jonathan M Morgan |
First Address | Clearwater, FL 33756 |
Second Address | Clearwater, FL 33756 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 04/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
16456 | BLUE CROSS BLUE SHIELD (01) | FL |
16456Z | (02) | FL |
272894000 | (05) | FL |